Basics Of Mobilization Flashcards
What are the steps of objective examination ?
- active range of motion
- passive range of motion
- accessory motions/ tests/ end feel
- special tests
Define flexibility
Flexibility refers to a musculotendinous unit’s ability to elongate under a stretching force. The amount of flexibility of a structure is related to its stiffness, suppleness ans pliability.
Prolonged loss of flexibility can reduce ROM.
Define range of motion
Range of motion is the amount of mobility of a joint and is determined by the soft-tissue and bony structures in the area. The status of tissues - blood vessels, muscles, tendons, ligaments, skin, subcutaneous tissues, nerves and capsule - all affect a joint’s ROM.
Define active range of motion
Is the range of motion that a joint achieves when moved actively by the patient. May also be referred to as active movement tests AMTs.
Define passive range of motion
It’s the range of motion of a joint passively moved by the therapist.
Passive ROM can be divided into physiological passive ROM and passive accessory ROM.
Define passive physiological range of movement
Passive physiological movements are performed when someone or something moves the segment/limb while the patient is relaxed, through the joint normal ROM.
Define the passive accessory range of motion
Is a component of joint movement that contributes to the overall physiological movement.
What are the causes of AROM limitation?
- muscle strength
- muscle length
- joint capsule
- ligaments
- pain
- swelling
- motor control/ CNS
Should PROM and AROM be the same ?
They should be similar but en PROM with overpressure will likely move the segment further than AROM.
What if a patient has greater PROM than AROM ?
Something is likely wrong with their ability to recruit the muscles to perform the movement
What if patient has the same AROM and PROM but the amplitude of the movement is under the normal ?
The joint is likely blocked or being stopped by factors other than muscle strength. It could be mechanical or caused by pain.
In which situations is the connective tissue associated with loss of AROM/ PROM ?
- patient exposed to long periods of bed rest
- fracture / immobilisation
- CNS pathology
- joint arthroplasty
Define connective tissue
Is a broad classification for non contractile tissues which are however playing a moderate role in the transmission of forces and movement.
It is continually replaced and reorganized as part of normal body function.
What is the composition of connective tissue ?
- elastin
- reticulin
- ground substance
- fibroblasts
What is elastin (connective tissue)
Elastin fibers provide structures with extensibility. These fibers can withstand elongation stress and return to initial length.
Tissues that have more elastin are more extensible.
What is reticulin (connective tissue)
Reticulin is essentially composed of collagen type III fibers
They play an important role during post injury repair process
What is ground substance (connective tissue) ?
Is a structure less organic gel like substance
It serves to reduce friction between the collagen and elastin fibers
It maintains space between the fibers to prevent excessive cross liking
It transports nutrients to the fibers
What are fibroblasts (connective tissue) ?
Fibroblasts are cells that create the connective tissue components
Why is collagen crucial for the musculoskeletal system ?
Collagen provides passive structural stability
It provides different tissues with strength and stiffness
Types I, II and III are the most present in the musculoskeletal system
What is collagen type I ?
Is very strong, has a high tensile strength, found especially in tendons and ligaments
What is collagen type II
Softer than type I, it is found in cartilage and spine
What is collagen type III ?
Is elastic, found in the skin, vascular structures
What are the effects of immobilization on connective tissue ?
Connective tissue tend to shorten but with daily activities it returns to its normal length.
Immobilization and disuse are sometimes necessary to protect the area and permit the healing process to occur.
The longer a part is immobilized, the more it will affect ROM.
Immobilization contributes to muscle atrophy and bone density loss
What are the neurophysiological effects of joint mobilization ?
Pain relief : neuromodulation at CNS level
Small amplitude joint mobilizations, oscillations
